Posterior cerebral artery infarct

A 73 year old male is brought by his grandson to the hospital because while sitting quietly at his house he suddenly developed a headache and he could not stand up. His past clinical history is positive for diabetes mellitus, hypertension, and chronic obstructive pulmonary disease. He is currently taking Captopril, Metformin, Tussend(antitussive syrup) and Trimethoprimsulfamethoxazole. The physical examination reveals blood pressure of 170/95, respiratory rate 14/minute, heart rate 90/minute and he has no fever. The patient is confused and does not recall what happened. The neurologic evaluation shows he has diminished strength and sensory loss on the right side of the body and he is unable to name colors. The patient also has a homonymous hemianopia. The lab tests shows:

Hgb 18 gm/l Hct 51.3% with normal differential and 480,000 platelets

Glucose 145 mg/dl

EKG atrioventricular dissociation

Cholesterol 320 mg/dl

Triglycerides 228 mg/dl

1-This man has an infarction of:

A-Middle cerebral artery

B-Anterior cerebral artery

C-Internal carotid artery

D-Posterior cerebral artery

E-None of the above

CORRECT ANSWER: D

2-This artery supplies:

A-Frontal lobe

B-Occipital lobe

C-Parietal lobe

D-All of the above

E-None of the above

CORRECT ANSWER: B

3-Occlusion of this artery can produce all EXCEPT:

A-Color agnosia

B-Hemianopia

C-Sensory loss

D- Hemiballismus

E-Aphasia

CORRECT ANSWER: E

4- Hemianopia is due to:

A-Diabetic neuropathy

B-Malignant hypertension

C-Secondary effect of one of the medications

D-Calcarine cortex involvement

E-None of the above

CORRECT ANSWER: D

5- The other symptoms or signs can this patient can show are:

A-Visual hallucinations

B-Thalamic syndrome

C-Alexia

D-Cortical blindness

E-None of the above

CORRECT ANSWER: D